Objective To study the HRCT features of pneumatized inferior turbinate and to evaluate their diagnostic value.Methods Twelve cases of pneumatized inferior turbinates demonstrated by HRCT were retrospectively analyzed.Results Coronal HRCT could demonstrate pneumatization of the inferior turbinate clearly and directly.Unilateral pneumatization was found in 11 cases and bilateral in one case. According to the location of pneumatization,pneumatized inferior turbinates were classified into three types : bulbous,lamellar,and extensive types.Five of 12 cases were bulbous,5 were lamellar and 2 were extensive type.On coronal HRCT scans,bulbous type showed nodular shape in one case,oval and ellipse shape in 2 cases each,respectively.Lamellar pneumatization appeared as curved stripe-like shape in 4 cases communicating with the maxillary sinus and ellipse shape in one case.Extensive type was found in 2 cases, curled lamella-like shape was found in 1 case communicating with the maxillary sinus and ellipse shape in another case.In 5 cases with maxillary sinus communication,axial HRCT revealed a defect on the medial wall of the maxillary sinus.In such a condition,the maxillary process of palatine bone and maxillary bone attached to the lower turbinate separately.Conclusion HRCT was an optimal imaging modality for the diagnosis of pneumatization of the inferior turbinate and may help the clinicians to differentiate from other causes of the inferior turbinate hypertrophy.

Objective To study the CT and MRI findings of osteosarcoma in paranasal sinus and evaluate their clinical value.Methods All 9 cases of osteosarcoma were verified by histopathology.Imaging data were analyzed retrospectively.Results The lesion occurred in maxillary sinus in 5 cases,in ethmoid sinus in 3 cases and in sphenoid sinus in one case.Primary osteosarcoma was found in 7 cases.Secondary osteosarcoma occurred from fibrous dysplasia and ossifying fibroma each in one case.On CT,the involved areas revealed bony destruction associated with ill-defined and irregular soft tissue mass.The lesion showed heterogeneous density with minimal or massive tumor bone formation,cloud-like in 3 cases,ivory-like in 2 cases,spicule-like in 2 cases,cloud- and spicule -like in one case and spicule- and ivory-like in one case.Postcontrast CT showed mild to moderate inhomogeneous enhancement in 3 cases.On MR T_1 WI,the lesions showed hypointensity compared to brain in 5 cases and iso-intensity in 2 cases.On T_2WI,the lesions showed heterogeneous hyperintensity in 4 cases and isointensity in 3 cases with marked hypointense foci which corresponded to tumor bone on CT.Postcontrast MR imaging demonstrated moderate to marked inhomogeneous enhancement in these cases.MRI showed accurately the extent and associated changes of the lesions.The lesions invaded the orbit,pterygopalatine and infratemporal fossae,skull base and extensive craniofacial structures in 5,4,3 cases and 1 case,respectively.Conclusion CT is the optimal modality in showing tumor bone of osteosareoma in paranasal sinus.MRI can demonstrate optimally the invading extent of the lesions.Combined imaging modalities can provide more comprehensive information for diagnosis and therapy of osteosarcoma in paranasal sinus.

Objective To investigate the CT and MRI findings of cavernous hemangioma in paranasal sinus so as to promote the diagnostic accuracy.Methods All 30 cases of cavernous hemangioma in paranasal sinus were verified with pathological examinations.The CT and MRI findings were analyzed retrospectively.Results The lesions occurred in the maxillary sinus in 25 cases,in the anterior ethmoid sinus in 3 cases and in the sphenoid sinus in 2 cases.The lesions extended and compressed adjacent structures.MRI showed the extent and the associated changes of the lesions more clearly compared to CT. On CT,all the involved paranasal sinuses invariably expanded.The bony walls of paranasal sinuses were compressed and remodeled with focal defect in 28 cases,mostly in the medial wall of the maxillary sinus (21 cases).Bony scelerosis of the residual walls of paranasal sinus were found in 8 cases.The lesions demonstrated well-defined margin and heterogeneous density with phlebolith in 10 cases.Postcontrast CT showed marked inhomogeneous enhancement in 16 cases.On MR T_1WI,canernous hemangioma showed hypointense signal compared to brain in 4 cases and isointense signal in 14 cases.On T_2WI,the lesions revealed heterogeneous hyperintense singal in 16 cases and isointense signal in 2 cases with multiple hypointense foci.Postcontrast MR imaging demonstrated marked inhomogeneous enhancement in these cases,honeycomb-like appearance in 8 cases and variegated appearance in 10 cases.The feature of progressive enhancement was found on dynamic contrast enhancement of MRI in 8 cases.Conclusions The characteristic bony change together with phlebolith can suggest the diagnosis of cavernous hemangioma in paranasal sinus on CT.The heterogeneous hyperintense singal on MR T_2WI,progressive enhancement and honeycomb-like or variegated appearance on postcontrast MRI were also the characteristic findings of cavernous hemangioma in paranasal sinus.Combination of CT and MRI findings can provide more accurate information for the diagnosis and therapy of cavernous hemangioma in paranasal sinus.

Objective To analyse the characteristics of orbital benign and malignant masses on diffusion weighted imaging in combination with conventional MR imaging and evaluate the diagnostic value of apparent diffusion coefficient in distinguishing benign and malignant orbital lesions.Methods Seventy- seven cases with orbital masses,including fifty-five benign lesions and twenty-two malignant tumors,who underwent conventional MRI and diffusion imaging scanning were studied with use of a 1.5 T magnetic resonance system.Quantitative ADC measurements of masses(ADC_M)and of the white matter of eontralateral temporal lobe(ADC_W)were made with two different b-values of 0 and 1000 s/mm~2.The ADC ratio(ADCR)of the lesion to the control was calculated.The receiver operating characteristic curves(ROC) were constructed using various cut points of ADC_M and ADCR for different parameters to differentiate between benign and malignant masses.The area under the ROC curve for each parameter was also calculated. Results All cases were proved by histopathology.The mean ADC_M and ADCR of benign orbital masses were(1.56?0.75)?10~(-3)mm~2/s and 1.85?0.91,respectively.The mean ADC_M and ADCR of malignant orbital masses were(1.09?0.42)?10~(-3)mm~2/s and 1.28?0.53,respectively.There were significant difference both between ADC_M and ADCR of benign and malignant masses(t=2.803,2.735,P

OBJECTIVETo explore the clinical effect of manipulative reduction and lateral percutaneous K-wire fixation on supracondylar humerus fractures.

METHODSFrom Feb. 2004 to Jun. 2010,128 cases of supracondylar humeros fractures in children (96 boys and 32 girls) were treated by manipulative reduction and lateral percutaneous K-wire fixation. The average age of the children was 8 years old ranging from 2 to 15 years. Among them, 112 cases were extension fractures, 16 were flexion type; 102 cases belonged to ulnar deviation, and 26 cases belonged to radial deviation. After treatment, the elbow flexion range and carrying angle of the children were measured under the Flynn evaluation standard while considering the postoperative complications status to analyze the clinical effect on manipulative reduction and lateral percutaneous K-wire fixation.

RESULTSAll these children were followed up from 2 to 36 months (16 months on average). According to Flynn evaluation standard,the result were excellent in 116 children (90.6% of the total patients), good in 11 (8.6%), fair in 1 (0.8%). No infection, no ischemic muscular atrophy and no nerve damage had been found during the treatment.

CONCLUSIONThe manipulative reduction and lateral percutaneous K-wire fixation of supracondylar humerus fractures in children has small wound, is stable and reliable, easy to be operated, safe and effective and low cost. What's more, it can also avoid the complication caused by conservative treatment and operation. It is a good treatment of supracondylar humerus fractures in children.

Adolescent ; Bone Wires ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; therapy ; Male ; Manipulation, Orthopedic ; methods

Objective To evaluate MR imaging findings of uveal metastases.Methods MR imaging findings of 20 cases with uveal metastases comfirmed by pathology or follow-up were retrospectively analyzed.MR imaging was performed in 20 patients,of which postcontrast T1-weighted imaging was performed in 19 patients including dynamic contrast enhancement scanning in four cases.Results Metastatic tumor was found in the iris and ciliary body in two cases,and in choroid in 18 cases.The tumor demonstrated slightly hypointense signal on Tl-weighted imaging and isointense signal on T2-weighted imaging in two cases,isointense signal on T1-weighted imaging and isointense signal on T2-weighted imaging in nine cases,isointense signal on T_1-weighted imaging and slightly hyperintense signal on T_2-weighted imaging in three cases,isointense signal on T_1-weighted imaging and slightly hypointense signal on T_2- weighted imaging in three cases,slighdy hyperintense signal on T_1-weighted imaging and slightly hypointense signal on T_2-weighted imaging in two cases,and slightly hyperintense signal on T_1-weighted imaging and slightly hyperintense signal on T_2-weighted imaging in one case.The tumor appeared as mild thickness of the wall of the globe in eight cases,a crescent mass in three cases,a fusiform mass in seven cases,and a nodule in two cases.Nineteen patients showed moderate or marked enhancement on postcontrast T_1-weighted imaging.The time-intensity curve of dynamic contrast enhancement in four patients suggested a rapid enhancement and slow washout pattern.Retinal detachment was observed in 11 patients and abnormal signal intensity within the vitreous body was seen in two cases.Conclusion MRI can display the location,shape, signal characteristics,and enhancement pattern of uveal metastases,contributing to diagnosis and differential diagnosis.

Objective Radiological findings of very rare hemangioendotheliomas in the orbit have not been reported.Radiological findings on different imaging studies of four cases with hemangioendotheliomas in the orbit were described and the literature was reviewed so as to understand features of hemangioendotheliomas in the orbit.Methods CT and MR imaging findings of four cases with hemangioendotheliomas in the orbit confirmed by histopathology were analyzed retrospectively.Results A mass was found in the superotemporal quadrant in the anterior extraconal space of the orbit in three cases and in the inferonasal quadrant in one case. CT studies revealed a homogeneously ovoid tumor with benign remodeling of the adjacent bone in three cases and a homogeneously irregular mass without any bony change in one case.MR imaging showed a mass in the orbit that was mildly hypointense on T_1-weighted sequences and hyperintense on T_2-weighted images with areas of flow voids representing vessels within the peripheral portion of the tumor in four cases.All four patients demonstrated significant enhancement immediately after intravenous administration of contrast material and a type D time-signal intensity curve (TIC)pattern on MR dynamic contrast enhancement scanning.Conclusions Hemangioendotheliomas in the orbit appeared as a hypervascular tumor predominantly in the extraconal space with areas of flow voids within the tumor and early significant enhancement of the tumor after intravenous administration of contrast material.MR imaging is the best method in demonstration of features of hemangioendotheliomas in the orbit and in diagnosis of these tumors.

OBJECTIVETo evaluate the safety and efficacy of thoraco-laparoscopic subtotal esophagectomy in the treatment of esophageal cancer.

METHODSClinical data of 98 patients with esophageal cancer who underwent thoraco-laparoscopic subtotal esophagectomy from March 2009 to October 2011 were retrospectively analyzed. One hundred and five patients were served as controls who underwent open three-field subtotal esophagectomy in the same period.

RESULTSThere were significant differences between thoraco-laparoscopic and open three-field subtotal esophagectomy in blood loss [(85.1±32.8) ml vs. (215.5±60.6) ml], length of stay [(12.7±3.5) d vs. (16.9±4.5) d]), pneumonia (4.1% vs. 12.4%, P<0.05), atelectasis (3.1% vs. 10.5%, P<0.05), pleural effusion (3.1% vs. 10.5%, P<0.05), acute respiratory distress (1.0% vs. 7.6%, P<0.05) and arrhythmia (4.1% vs. 12.4%, P<0.05). No significant differences were observed in the number of lymph node harvested, operative time, anastomotic leak, thoracic abscess, chyle chest, re-laparotomy, re-thoracotomy, vocal cord paralysis, renal failure, gastric emptying, and mortality (all P>0.05).

CONCLUSIONThoraco-laparoscopic subtotal esophagectomy is technically feasible and safe and is associated with less blood loss, less cardiopulmonary complication, and shorter hospital stay.

Aged ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Laparoscopy ; Lymph Node Excision ; Male ; Middle Aged ; Retrospective Studies ; Thoracoscopy ; Treatment Outcome

OBJECTIVETo evaluate the value of a new platelet function test PFA P2Y (PFA-200) in monitoring clopidogrel treatment for cardiovascular disease in elderly patients.

METHODSFifty-six elderly patients receiving clopidogrel therapy in the Department of Cardiology of General Hospital of PLA from March to August in 2016 and 85 healthy volunteers were recruited for analysis. All the subjects underwent PFA P2Y, LTA (light transmittance aggregometry) and TEG (Thromboelastograph) tests, and Spearman correlation coefficients were used to test the associations between test results. The agreement among the 3 platelet function test methods was assessed using Cohen's kappa coefficient.

RESULTSCorrelation coefficient (r) was -0.701 (P<0.001) between PFA P2Y and LTA, and 0.475 (P<0.001) between PFA P2Y and TEG. The agreement was 75% between PFA P2Y and LTA and 67.9% between PFA P2Y and TEG. The κ value was 0.434 (P=0.001) between PFA P2Y and LTA and 0.242 (P=0.046) between PFA P2Y and TEG. With ADP-induced maximum platelet aggregation rate of LTA >50% as the laboratory clopidogrel resistance, the cut-off value of PFA P2Y was 119 s (AUC=0.733) with a sensitivity of 75.6% and a specificity of 73.3%.

CONCLUSIONPFA P2Y has a moderate correlation and agreement with LTA, but has a poor correlation and agreement with TEG. PFA P2Y can be useful for assessing the effects of clopidogrel therapy and the association of the cut-off value (119 s) with the long-term clinical ischemic events needs be confirmed in further study.

Biological Assay ; Blood Coagulation Tests ; Blood Platelets ; Cardiovascular Diseases ; drug therapy ; Humans ; Platelet Aggregation ; Platelet Aggregation Inhibitors ; therapeutic use ; Platelet Function Tests ; Sensitivity and Specificity ; Ticlopidine ; analogs & derivatives ; therapeutic use

OBJECTIVETo verify the effects of treatment with blood transfusion and scopolamine on severe chlorphenamidine poisoning (SCP).

METHODS400 patients with severe oral chlorphenamidine poisoning were randomly divided into two groups. 200 patients (Group I) were treated with the traditional combined therapy including gastrolavage, purgation and taking redox agent (methylene blue and vitamin C) while the other 200 patients (Group II) in addition to the above mentioned therapy, received blood transfusion and scopolamine injection.

RESULTSThe cure rate of Group II was 99.5% and significantly higher than that of Group I (91.0%, P < 0.01). The average time of improving in health in Group II [(8.71 +/- 1.49) h] was obviously shorter than those in Group I [(10.65 +/- 1.72) h, P < 0.01]. Blood methemoglobin concentrations in Group II at 3, 7, 12, 24 h after admission [(43.58 +/- 2.69), (34.21 +/- 2.30), (20.60 +/- 4.03), (13.50 +/- 1.65) g/L respectively] were obviously lower than those in Group I [(54.42 +/- 12.79), (42.17 +/- 22.34), (30.66 +/- 17.67), (19.01 +/- 0.61) g/L respectively, P < 0.01].

CONCLUSIONBlood transfusion and scopolamine had distinctive therapeutic effect on SCP to makeup the deficiency of redox agent. Combination of three therapies may potentiate the detoxication for chlorphenamidine.

Adult ; Antioxidants ; therapeutic use ; Blood Transfusion ; Chlorphenamidine ; poisoning ; Drug Therapy, Combination ; Female ; Humans ; Insecticides ; poisoning ; Male ; Mydriatics ; therapeutic use ; Poisoning ; therapy ; Scopolamine Hydrobromide ; therapeutic use ; Treatment Outcome